NUR 2459 / NUR2459 Mental and Behavioral Health Nursing Exam 2 Study Guide | Rated A | Latest 2020 / 2021 | Rasmussen College

1)      Your patient with acute mania now seems to be responding well to treatment, how are you able to tell.

-      Participating in groups, taking turns speaking, appropriately dressed.

2)      Pick healthy coping strategies,

-      Exercise

-      Journaling

-      Using learned coping strategies

3)      Your patient tells you “They are after me, they want to kill me”, what is your best response?

-      That must make you scared, how does that make you feel?

4)      Your patient is experiencing auditory hallucinations, what is your next step?

-      Ask your patient what the voices are saying.

5)      Should you assess for depression and suicidal ideation in a schizophrenic patient

-      Yes

14.  Anhedonia

-      Anhedonia is the inability to feel pleasure. It's a common symptom of depression as well as other mental health disorders. Most people understand what pleasure feels like.

15.  Anergia

-      Abnormal lack of energy is among the negative symptoms common to schizophrenia and depression.

16.  SSRI patient/family teaching points

-      Medications of any kind — prescribed, over-the-counter, or herbal supplements — should never be mixed without consulting the doctor

-      Alcohol (wine, beer and hard liquor) or street drugs, may reduce the effectiveness of antidepressants

-      Avoid consuming certain foods that contain high levels of tyramine, such as many cheeses, wines and pickles.

17.  Lithium adverse reactions

-      Excessive urination and thirst (polyuria and polydipsia) are consistently found to be among the most common side effects associated with lithium

-      Hives; difficulty breathing; swelling of face, lips, tongue, or throat.

-      Too much lithium in body can cause death.

18.  What activities can put someone at risk for lithium toxicity?

-      Lithium toxicity can occur if you take only slightly more than a recommended dose. Risk factors for lithium toxicity include older age and factors that lead to disturbances in renal blood flow and water-salt homeostasis, such as fever, diarrhea or vomiting, and use of nonsteroidal anti-inflammatory drugs (NSAIDs), diuretics, and renin- -angiotensin-aldosterone system (RAAS) inhibitors. Female sex has also been associated with a higher risk of lithium toxicity

19.  Lithium patient education – teaching points

-      Stop using lithium and call the doctor for symptoms of lithium toxicity: muscle weakness, twitching, drowsiness, feeling light-headed, mood changes, blurred vision, ringing in the ears, irregular heartbeats, confusion, slurred speech, clumsiness, trouble breathing, or seizures.

-      Some medicines can interact with lithium and cause a serious condition called serotonin syndrome

20.  Assessment of Suicide, what would be considered a high-risk assessment?

-      Communicating suicidal thought

-      Verbally or in writing; seeking access to lethal means such as firearms or medications; and demonstrating

-      Preparatory behaviors such as putting affairs in order.

21.  St. John’s wort considerations

-      St. John's wort might cause serious interactions with some medications.

-      St. John's wort is most commonly used for "the blues" or depression and symptoms that sometimes go along with mood such as nervousness, tiredness, poor appetite, and trouble sleeping.

-      It can cause some side effects such as trouble sleeping, vivid dreams, difficulty sitting still, nervousness, irritability, stomach upset, tiredness, dry mouth, dizziness, headache, skin rash, diarrhea, and skin tingling.

22.  Symptoms of Bipolar manic episode

-      An individual with bipolar disorder may have manic episodes, depressive episodes, or “mixed” episodes.

-      Abnormally upbeat, jumpy or wired.

-      Increased activity, energy or agitation.

-      Exaggerated sense of well-being and self-confidence (euphoria)

-      Decreased need for sleep.

-      Unusual talkativeness.

-      Racing thoughts.

-      Distractibility.

23.  Symptoms that could be attributed to child/adolescent depression

-      Feeling sad, hopeless, or irritable a lot of the time

-      Not wanting to do or enjoy doing fun things

-      Showing changes in eating patterns – eating a lot more or a lot less than usual

-      Showing changes in sleep patterns – sleeping a lot more or a lot less than normal

-      Showing changes in energy – being tired and sluggish or tense and restless a lot of the time

-      Having a hard time paying attention

-      Feeling worthless, useless, or guilty

-      Showing self-injury and self-destructive behavior

6)      What medications are examples of MAOI’s

-      Phenelzine (Nardil)

-      Selegiline (Emsam)

7)      Your patient is about to start taking Phenelzine (Nardil), you as a nurse should include in your education plan (SATA)

-      Aviodance of foods high in tyramine

-      Check with the pharmacist before taking any OTC (examples are cold medications)

8)      What is the risk of taking an SSRI and MAOI inhibitor together (SATA)?

-      Serotonin syndrome

-      Hypertensive crisis

9)      Your bipolar patient is making demands and disrupting the unit, how do you respond (SATA)

-      Set clear limits

-      Distraction techniques

-      Use a firm calm approach

10)  High level suicide precautions for inpatients include SATA

-      1:1 staff within arm’s length of patient at all times

-      Removal of any hard removals at meal times

-      Removal of anything that the patient potentially uses to harm themselves

11)  When can a patient stop taking their mood stabilizer?

-      They should not stop taking their mood stabilizer.